Pre-analytical workstations: A tool for reducing laboratory errors

Abstract

Laboratory testing, a highly complex process commonly called the total testing process (TTP), is usually subdivided into three traditional (pre-, intra-, and post-) analytical phases. The majority of errors in TTP originate in the pre-analytical phase, being due to individual or system design defects. In order to reduce errors in TTP, the pre-analytical phase should therefore be prioritized. In addition to developing procedures, providing training, improving interdepartmental cooperation, information technology and robotics may be a tool to reduce errors in specimen collection and pre-analytical sample handling. It has been estimated that > 2000 clinical laboratories worldwide use total or subtotal automation supporting pre-analytic activities, with a high rate of increase compared to 2007; the need to reduce errors seems to be the catalyst for increasing the use of robotics. Automated systems to prevent medical personnel from drawing blood from the wrong patient were introduced commercially in the early 1990s. Correct patient identification and test tube labelling before phlebotomy are of extreme importance for patient safety in TTP, but currently few laboratories are interested in such products. At San Bassiano hospital, the implementation of advanced information technology and robotics in the pre-analytical phase (specimen collection and pre-analytical sample handling) have improved accuracy, and clinical efficiency of the laboratory process and created a TTP that minimizes errors.